Guest columnist Constance Leshin writes about the early days of two of her long-time friends’ walk through Alzheimer’s. Ed.

Alzheimer’s strikes Neuro-physiologist

It was on an early Fall evening and I was standing outside in a small town in Northern California with two long-time friends, now in their eighties. We were looking at the starry sky and suddenly Ilsa remarked, “There is Jupiter!”

Her husband, Al, and I disagreed and pointed out that it was moving and therefore, an airplane.

It was a lucid moment for the three of us and for just a moment, I forgot that Al, a retired neuro-physiologist, was no longer the brilliant, well-read, and conversational person that I knew years ago but rather a confused and mostly nonverbal man stricken with Alzheimer’s disease. His wife, Ilsa, wasn’t too far behind living with the stress and frustration of taking care of Al along with their forty-seven-year-old daughter, Michelle, who suffers from schizophrenia.

Childhood friend no longer remembers name

On that same trip, I visited Anne who lives in Berkeley, a once bright and creative PhD who now cannot remember my name at times. We have known each other since childhood and are second-generation friends.

Our relationship is based in the present.

Anne appears to be in the early stages of Alzheimer’s* and has the diagnosis of mild cognitive impairment. She keeps files on her friends so that she can read about them but then promptly forgets what she has read. Her memories are recorded in a tiny black notebook that is crammed full of information on the content of her days.

According to the National Institute of Health, it is not known what starts the Alzheimer’s disease process. Damage to the brain begins as many as 10 to 20 years before any problems are evident. Tangles begin to develop deep in the brain, in an area called the entorhinal cortex, and plaques form in other areas. As more and more plaques and tangles form in particular brain areas, healthy neurons begin to work less efficiently. They lose their ability to function, to communicate with each other, and eventually die. This damaging process spreads to a nearby structure, called the hippocampus, which is essential in forming memories

It won’t matter if she forgets my name. What will matter is that we can still be together, laugh, play and enjoy the day.

Experts suggest that as many as 5.1 million Americans may have Alzheimer’s. It is named after Dr. Alois Alzheimer who in 1906, noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain where he found many abnormal clumps (amyloid plaques) and tangled bundles of fibers (neurofibrillary tangles). Plaques and tangles in the brain are two of the main features of Alzheimer’s disease. The third is the loss of connections between nerve cells (neurons) in the brain.

I chat with my friend Anne on a regular basis.

Sadly, she tells me that her memory issues are getting worse. I promise to fly back to visit her within the next few months. We will spend our time taking walks, playing card or board games or doing some simple arts and crafts.

Our relationship is based in the present. I will continue to remind her of who the members of my family are, where I live, and what I do. It won’t matter if she forgets my name. What will matter is that we can still be together, laugh, play, and enjoy the day.

Constance Leshin
Columnist & Friend of Loved Ones with Alzheimer’s

*Editor’s note: Not all diagnoses of memory loss due to mild cognitive impairment (MCI) lead to Alzheimer’s.